| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0570 |
Nebulizer, with compressor |
427 |
392 |
$20K |
| E0601 |
Continuous positive airway pressure (cpap) device |
79 |
67 |
$3K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
390 |
343 |
$2K |
| A6196 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing |
27 |
22 |
$2K |
| A6252 |
Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing |
44 |
32 |
$1K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
14 |
13 |
$1K |
| A6266 |
Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard |
17 |
13 |
$1K |
| A6260 |
Wound cleansers, any type, any size |
33 |
27 |
$813.86 |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
14 |
13 |
$645.18 |
| A4452 |
Tape, waterproof, per 18 square inches |
48 |
41 |
$484.88 |
| K0001 |
Standard wheelchair |
24 |
24 |
$335.68 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
110 |
108 |
$182.13 |
| A7015 |
Aerosol mask, used with dme nebulizer |
119 |
114 |
$132.02 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
13 |
12 |
$74.92 |
| A4450 |
Tape, non-waterproof, per 18 square inches |
39 |
32 |
$70.44 |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
15 |
13 |
$59.73 |
| A4217 |
Sterile water/saline, 500 ml |
18 |
13 |
$0.00 |